Spotlight on: Different Types of BS/MD Programs

When narrowing down your potential list of colleges, one of the most important factors to consider is the number of schools you’re applying to. Most guidance counselors recommend applying to anywhere from 8-12 colleges. Any number beyond that, they warn, can cause unnecessary stress and anxiety for students. And while this may be a valid point for any normal high school senior, any student looking to apply to BS/MD programs has to be cautious of such advice.

When I was first considering which schools to apply to, I had originally short-listed about 25 colleges. And while I was well aware and ready to dedicate all the time, effort, and money required into these applications, my guidance counselor did not have that same confidence. She warned me multiple times that this many applications were unnecessary, and that I needed to narrow the focus of my list a bit more. But what she didn’t understand was that when you’re applying to BS/MD programs, application season is a little different.

First, you have to note down a list of regular undergraduate schools that you’d like to apply to. This takes into account your safety schools, target schools, and reach schools. But in addition to that, you have to make another list of all the BS/MD programs that you want to apply to. Now the unfortunate part of BS/MD schools is that even if you’re only interested in the school for their program (which is a debatable topic that’s further discussed below!) you still have to complete their entire regular undergraduate application. The upside, however, is that if you’re interested in both the undergraduate school on its own as well as with the program, then there is only slightly extra effort you have to put in to apply to the program. This sort of overlap is extremely convenient and is the best way to get your total number of colleges down.

But before narrowing down your college list, you’ve got to decide what you’re looking for in a potential college. With regards to regular undergraduate schools, the normal conditions apply: how big is the school, what subjects is it known for, what types of extracurricular activities are available, etc. When it comes down to BS/MD programs, however, there are additional details that need to be considered. Below, I’ve listed some of the most important questions to ask when deciding which programs are best suited for you.

How long do you want your undergraduate career to last?

BS/MD programs can last anywhere from 6-8 years, with 6 year programs being slightly less common than 7 or 8 year programs. The benefit of 6 or 7-year programs is that they allow you to accelerate your study of medicine by a few years. It’s no secret that becoming a doctor takes near 12-years of study, and for some people, minimizing that time is of utmost importance. Not only that, but by cutting your undergraduate education short, you get to save up some extra money that you can later use to fund medical school. The only downside to these accelerated programs is the quicker pace of study. 6-year programs will almost always require you to take summer classes while 7-year programs may at least recommend doing so (especially if that 7-year program requires taking the MCAT).

The best way to find out if an accelerated program is right for you is to determine how organized and confident you are what you want to study/how you want to pursue your interests during your undergraduate years. Any accelerated program requires that their students be extremely proactive in terms of planning. It’s difficult to switch around majors and incorporate things such as study abroad (though it has been done before!) due to the limited time available. Depending on the program, though, there is some freedom given to you for extending your undergraduate times if you wish to do so.

8-year programs, on the other hand, have a completely different goal in mind. The purpose of these programs is to enrich your undergraduate education rather than accelerate it. Many of them, in fact, do not even allow students to enter medical school prior to four years of undergraduate education. Now that doesn’t mean you need to spend all those 4 years in school. Some people choose to graduate in 3 years and use the fourth year to take advantage of fellowship offers, study abroad programs, or pursue a graduate degree in some other subject. And if four years still isn’t enough time to accomplish all of your goals before medical school, then go ahead and take some gap years in between. In general, these programs tend to be flexible with increasing your education time before medical school but strictly enforce at least a four-year minimum. And that’s simply because they don’t any student to come into this program with the goal of accelerating their education; the goal is always enrichment.

In my opinion, one of the greatest advantages of an 8-year program over an accelerated program is the acceptance of uncertainty. On average, the typical undergraduate college student changes his or her majors 3-4 times, and having the freedom to do so is one that should not be taken for granted. I can speak from personal experience on this; coming into college, I thought I knew exactly what I wanted to study and had a full 4-year plan sketched out of every class I was going to take. But by the end of my first semester freshmen year, I was doubting my major choice simply because I had heard from older students that my academic department of interest wasn’t as strong as I’d hoped for. So at that point, I had to opt for a new major and completely change up my entire 4-year plan. But again, by the end of my second semester of freshmen year, I was doubting my new major choice because I didn’t love it as much as I thought I would, so I ended up keeping it as just a minor. At this point, I was back to square one with no major in mind even though one year of college had already gone by. But the point is, its okay to be unsure. In fact, it’s quite natural for your interests to change in college. No matter how confident you are in your choice of study or extracurriculars prior to entering college, something or another is going to change, and you are going to have to make adjustments in order to accommodate for those changes. In an 8-year program, its far easier to make adjustments than it is in an accelerated program, and it’s a freedom that I personally value quite highly.

What interests are you planning to pursue in college?

This is an extremely important question when deciding which BS/MD program is best suited for you. While some programs strongly encourage (perhaps even require) research and clinical experience during your undergraduate years, others want their students to focus more time on liberal arts activities and get a more holistic understanding of medicine. With some research of the undergraduate university, it is quite easy to determine the program’s focus (since most programs endorse the whatever philosophy holds true to the undergraduate school). There are, however, also schools that completely leave it up to you by minimizing requirements and maximizing opportunities. Take, for example, the BS/MD program that I am currently enrolled in: REMS at the University of Rochester. Though the undergraduate school is known for their strong research facilities, they also require students to take courses in all three-subject areas of Social Sciences, Humanities, and Natural Sciences. Due to the dual focus of the university, it is very easy to get involved with whatever you want, whether that be more research-oriented interests or liberal-arts oriented interests. And on top of that, the REMS program puts no requirement on you for any specific extracurriculars. As a result, the amount of diversity present amongst REMS students is large; about 50% of students are natural science majors and the other 50% are social science or humanities majors. Not everyone gets involved in research, and even if they do, it might not be the traditional lab-research that everyone associates with pre-meds. A large part of my college application was explaining how I’ve balanced science and art my entire life; with Rochester though, I didn’t have to choose. Some people may be more drawn to one area of study, and if that’s the case, then there is no point in going to a program that encourages an alternative area of study. It’s all about finding what program aligns with your interests, and the only way to determine that is through research.

Are you willing to stay in the same location for an extended period of time?

When I had finally decided to commit to U of R for REMS and starting informing friends and teachers of my decision, the most common reaction I got back was “Wow, congrats! But you’re really willing to stay in one place for 8 years?” This question confused me, since most of the people who asked it had been living in the same city (or at least nearby) for a good majority of their lives. But I guess what most people assume is that they’ll go to college in one city for 4-years and then hopefully relocate for graduate school or job purposes. To some people, location may be a factor of great importance (especially if you get there and find out you hate the area), and it is definitely something to consider when applying to BS/MD programs. Not all programs have the undergraduate school in the same city as the medical school (for example, the Baylor/Baylor program has Baylor University in Waco, Texas but Baylor College of Medicine in Houston, Texas), but many of them do. So just to be safe, it’s best to do some research on it beforehand and make sure you’re really ready to commit to one general area for the next few years.

How important is avoiding the MCAT?

According to older pre-med students, taking the MCATs is one of the most dreaded parts of being a pre-med. It’s an 8-hour test that requires extensive knowledge and commitment because it cumulatively tests everything you’ve learned since day one of freshmen year. The MCAT, in fact, is one of the biggest roadblocks that prevents pre-med students from pursuing interests such as studying abroad. And that’s exactly why many BS/MD programs allow for their students to opt out of taking it, so that they can use that time they would spend studying on other, more enriching experiences.

Unfortunately, not all programs exempt you from taking the MCAT. Instead, they require that you get a minimum score (usually slightly lower than that medical school’s average MCAT score) to be guaranteed admission into the medical school. Of course, no MCAT is usually preferable to a lower score on the MCAT, but that doesn’t mean you should automatically cross out any program that requires the MCAT off your list. In fact, there can be several benefits to taking the MCAT.

One of the most critiqued aspects of BS/MD programs without the MCAT is that their students will be disadvantaged when it comes time to take their USMLE (another standardized test) in medical school. Though I have several friends who have debunked this theory with their own education, it is still a point of valid concern for many students. In that case, perhaps a program that requires you to only achieve a minimum score is ideal. That way, you get the experience of taking a large, standardized test but get to do so without having to overstress about getting the highest score possible. Alternatively, some students might prefer to avoid the MCAT altogether simply because they do not perform their best under standardized testing conditions, in which case a program without MCAT requirements is optimal. It all comes down to personal preference, but this is definitely a question that should be addressed when deciding which programs to apply to.

How prestigious does the undergraduate school need to be?

Disclaimer: By no means am I trying to talk down to any undergraduate school in this section below. Instead, I am simply trying to shed light on a controversial topic that students entering BS/MD programs deal with all the time.

One of the biggest dilemmas that BS/MD applicants face when it comes time to commit to college is how much weight they should put on the “prestige factor” of their undergraduate university. Even though acceptance rates for several BS/MD programs are much lower than those of even the most competitive ivy-league schools, that doesn’t take away from the fact that most of the undergraduate universities part of these BS/MD programs are ranked lower (sometimes substantially so) than those ivy-league schools. Deciding where to commit to is an extremely personal decision, and with options as great as these, you really can’t go wrong. I have friends who have turned down renowned universities including Stanford, Harvard, and MIT simply for a slot in one of these programs. On the flip side, though, I also have friends that have turned down some of the most competitive BS/MD programs to instead attend ivy-league standard schools including Yale, UC Berkeley, and Princeton.

My strongest piece of advice for students leaning towards accepting a BS/MD offer is to make sure you are truly happy with the undergraduate school, even if it is not as highly ranked as some of your other university options. I can remember back to the fall of my senior year when I was so desperately hoping to get into any BS/MD program, regardless of how good or bad the undergraduate university was. Of course, my aspirations were towards programs like Brown University’s PLME, which combined both an excellent undergraduate school with a well-ranked medical school. But when you’re in that deep into application season and are questioning how you could ever go through this entire process all over again, just about any BS/MD program looks promising.

Now, however, having just completed my freshmen year of college and reflecting back to those days, I can’t imagine what I was thinking. I know for a fact that if I had decided to go to a undergraduate university that I didn’t like simply because of the conditional medical school acceptance it was offering, I would have hated it. So much so that I might have even transferred schools. Your undergraduate career is a time to challenge yourself, both intellectually and socially; it’s an exciting part of your life where you get to grow and push yourself to be better. If, however, you choose to go to an undergraduate school that doesn’t excite you or challenge you in any way, then you will never have the motivation needed to reach your full potential.

Previously, I had categorized BS/MD applicants into two different types: those who had turned down BS/MD programs for ivy-league schools and those who had turned down ivy-league schools for BS/MD programs. But I omitted perhaps the most important category of all: those who had regretted the decision they made. These are the students who’s perspective you should really try to understand and ask yourself if you could possibly see yourself having some of the same regrets in the future. Students who regretted choosing a BS/MD program felt so most likely because either (1) they didn’t feel challenged by their peers and professors or (2) they ended up deciding that medicine wasn’t for them and had wished their resume now had a slightly more prestigious undergraduate university on it. Students who regretted choosing an ivy-league type school over a BS/MD program, on the other hand, likely felt so because (1) they felt the stresses and time commitment required to be a successful pre-med was not worth the extra “prestige” factor, or (2) the competition was so fierce that they eventually had to consider an alternative career route because their GPA and MCAT scores were not high enough for medical school.

It is, of course, impossible to predict what obstacles you are going to face in the future. And no matter what you decide, there will always be some “what if” questions still lingering in your mind. The goal isn’t to avoid those questions, though; instead, it’s to avoid regretting your decision in its entirety. The best way to come to a decision, then, is to make sure you’re committing to a university truly because you believe you will be happy there, not simply because it’ll provide you with an “easier” route to medical school or because it’s a more “prestigious” university. Of course those should be points of consideration, but they should not be the only reason for your decision. If medicine is truly your calling, then one way or another, you will get there. And if somewhere along the way you decide medicine isn’t for you, then you should still be happy with the undergraduate university you chose.

Can you afford it?

The final point to consider when applying to a BS/MD program is financial restrictions. Though most people don’t look into this matter too heavily until they’re strongly considering committing to a university, it is a topic to keep in the back of your mind when applying to BS/MD programs. A good majority of these programs have two stages to their application process: (1) an essay portion that is included in addition to your regular undergraduate application, and (2) an on-campus interview with the medical faculty. Of course it’s always exciting to get an interview offer, but the downside to that is that you often have to spend money buying plane tickets/taking long road-trips and book hotels. Unfortunately, these interviews are a non-negotiable part of the application process, so there is no way you can convince the selection committee to offer you acceptance even though you could not make the interview due to financial restraints. The only way to minimize monetary costs, then, is by being very selective with which schools you travel to for an interview. If you apply to a program that’s perhaps you’re not 100% interested in attending but still end of getting an interview, do not waste your time and money traveling to campus unless you are serious about accepting a potential offer from them.

The other downside to BS/MD programs is that once you have been accepted into the program, not all of them offer great financial assistance to their students. And they do so strategically. These programs know that a conditional acceptance to medical school is of great value, and they try to use that as leverage when determining how much scholarship money to give you. As a result, don’t be too surprised if a university with a BS/MD program doesn’t match scholarship offers you’ve received from other, regular undergraduate universities (no matter how prestigious they may be). And don’t at all be surprised if these schools provide you with no money towards medical school. For people with financial restraints, the best programs to apply to are those at public, instate universities. They often provide a bit more scholarship money, and even if they don’t, their tuition prices are already significantly lower than those of private schools.

So to recap, the six questions you should ask yourself when applying to BS/MD programs are:

How long do you want your undergraduate career to last?

What interests are you planning to pursue in college?

Are you willing to stay in the same location for an extended period of time?

How important is avoiding the MCAT?

How prestigious does the undergraduate school need to be?

Can you afford it?

Applying to BS/MD programs is no joke; it takes a large amount of planning to be successful at it. But if you start early enough and do enough research before sending in your application, then you’ll maximize your chances of finding a program that best fits you.